Nishiyama T, Hanaoka K
Department of Anesthesiology, University of Tokyo, Faculty of Medicine, Japan.
Eur J Anaesthesiol. 1998 May;15(3):275-9. doi: 10.1017/s0265021598000520.
We have studied the optimal diluent volume for post-operative analgesia and sedation produced by epidurally administered midazolam after upper abdominal surgery. Sixty patients were randomly allocated to four groups of 15 patients. When patients complained of pain after surgery, epidural midazolam 0.05 mg kg-1 in 3 mL saline (Group A), in 5 mL saline (Group B), in 10 mL saline (Group C) or in 15 mL saline (Group D) were injected as a bolus. The sedation was better and lasted longer in groups B and C than in the other two groups. Groups B and C also had significantly more extensive areas of analgesia than groups A and D from 30 min after the administration of midazolam. The interval to the second request for an analgesic was significantly shorter in Group D than in the other three groups. Memory retention of the pin-prick examination was reported by four patients in Group A. The present results indicate that 5-10 mL saline is the optimal volume for epidural injection when using midazolam 0.05 mg kg-1 for post-operative analgesia following upper abdominal surgery.
我们研究了上腹部手术后硬膜外注射咪达唑仑产生术后镇痛和镇静的最佳稀释液体积。60例患者被随机分为4组，每组15例。术后患者主诉疼痛时，分别将0.05 mg/kg咪达唑仑溶于3 mL生理盐水（A组）、5 mL生理盐水（B组）、10 mL生理盐水（C组）或15 mL生理盐水（D组）中作为 bolus 注射。B组和C组的镇静效果优于其他两组，且持续时间更长。从注射咪达唑仑后30分钟起，B组和C组的镇痛范围也明显比A组和D组更广。D组第二次要求使用镇痛药的间隔时间明显短于其他三组。A组有4例患者报告对针刺检查有记忆保留。目前的结果表明，当上腹部手术后使用0.05 mg/kg咪达唑仑进行术后镇痛时，5 - 10 mL生理盐水是硬膜外注射的最佳体积。
